Sunday, April 26, 2015

Brihan-Mumbai Municipal Corporation (BMC) has taken a big step towards standardisation of indications for prescribing antibiotics for use by various specialties(1). This is said to be the first time any Civic Agency has taken such a step. The Corporation, one of the richest in the country, has taken this big step in the right direction.

On the same note, it remains to be seen how much of the policy is followed by the doctors. Rational use of antibiotic was a necessity in the period of world war due to acute shortage. In the present day, there is no dearth of antibiotic availability but they are not effective enough to combat tough infections. In 2013, BMC started this ambitious project to curb the abuse of antibiotics(2). Over a period of 2 years, various expert committees convened to draft an antibiotic policy for use by each of their specific specialties. And this has culminated in the release of the policy in it's current form.

A couple of years ago, a medical intern lost her life to Multi-Drug Resistant Tuberculosis in Mumbai which was shocking but raised the concerns among the trainees and students in medical colleges all over Maharashtra. The issue of antibiotic resistance is pandemic as World Health Organisation (WHO) claims and all countries irrespective of their development status are afflicted by antibiotic resistance challenges. In the present scenario, development of such a policy is the need of the hour. But what these policies fail to address is that if the policy recommends antibiotics for a particular diagnosis, the challenge is that most cases do not fit that particular diagnostic criteria. Moreover doctors still err on the side of defensive prescription of antibiotics rather than following a system of watchful waiting.

The only way to inculcate these principles is when the training curriculum of medical fraternity stresses on these aspects at every level of the training from their undergraduate levels to the post graduate levels and beyond. Also the associations of medical fraternity must all stress the same to their respective specialties and members. Let's hope rational use of antibiotics becomes the norm before the antibiotics themselves become irrational (useless).